Essential Case Readings on Competency and Insanity

Instructor: Paul G. Mattiuzzi, Ph.D.

Not currently being offerred for credit

Course Description

This course directs the attention of criminal forensic psychologists to a series of critical, practice related concepts that are given in a set of historic appellate and Supreme court rulings. These case readings span two areas of forensic inquiry and assessment: competency to stand trial and insanity. This course is not intended to substitute for a basic understanding of the relevant law, and it is not meant to provide comprehensive training in either area of practice. Instead, this course seeks to illustrate a number of "finer points" that are not explicit in statute and which can only be learned through case law examples. The learning task in this course is accomplished by the reading of eight different judicial decisions. Each of these cases provides discussion of one or more salient legal points, the understanding of which is essential to the advanced practice of criminal forensic psychology. In addition, each of these cases provides a rich and complex case history that demonstrates both the application and interpretation of a legal standard. Each case enhances the practitioner's appreciation of legal reasoning, and the application of law to a specific set of facts. All of these cases describe the motivations, behavior and mental functioning of the offender involved and would be usefully considered as case examples for forensic practitioners, even in the absence of the particular ruling. There is a specific point to be learned from each of the eight readings, and from each, there are additional insights to be gained with respect to the role of the psychologist in the criminal process.

These materials are relevant in California, and my not be relevant elsewhere.

Each reading will open in a new window. Close that window to return here.  All of the materials associated with this course are in the public domain, except this page. This page is copyrighted, 2004.

Criminal Forensic Psychology: Essential Case Readings on Competency and Insanity

20 Minutes Dusky v. United States: Dusky is the foundational case establishing the standard for competency to stand trial. It is cited in virtually every study and publication discussing competency and is the basis for the most common and frequent type of forensic assessment conducted by psychologists. In addition to its description of the standard, this case is of interest for its sparse language, and it is notable for the fact that it provides no foundation, explanation or reasoning for the ruling.

60 minutes
Pate v. Robinson: Cited in subsequent rulings, Pate v. Robinson establishes that the conviction of an incompetent defendant violates the 14th Amendment right to due process. In doing so, it provides an underlying conceptual and legal foundation for the competency standard that is missing from the Dusky ruling. In addition, the facts in this case illustrate the complexities involved in distinguishing between mental state at the time of the offense (insanity) and mental state at the time of trial (competency).

60 minutes
Godinez v. Moran: This case is primarily concerned with the distinction between competency to stand trial, competency to waive counsel, and competency to plead guilty. It alerts the practitioner to the relevant standards (or the indistinguishable standards) associated with each decision. Of perhaps greatest interest in this case is the dissenting opinion that refers back to Pate v. Robinson, reiterating the due process foundation for competency findings, and which discusses the common law history of the incompetency standard.

Comment:   Dusky establishes the basic standard for competency.  In Pate and Godinez, the Court establishes an underlying Constitutional basis for competency.   The Court is basically saying, "if you are not competent, you cannot enjoy due process."   So how do we translate this into language that is useful in a competency report?   You should think of it in terms of the 6th Amendment to the Constitution, which reads as follows:

"VI. In all criminal prosecutions, the accused shall enjoy the right to a speedy and public trial, by an impartial jury of the state and district wherein the crime shall have been committed, which district shall have been previously ascertained by law, and to be informed of the nature and cause of the accusation; to be confronted with the witnesses against him; to have compulsory process for obtaining witnesses in his favor, and to have the assistance of counsel for his defense."

For the purpose of reporting on an offender's competency, the questions for the psychologist are the following:

If the offender is not capable of understanding the nature and purpose of the proceedings against him, how can he enjoy his right to be informed of the nature and cause of the accusation?

And if the offender is not capable of assisting counsel in conducting his defense in a rational manner, how can he enjoy his right to have the assistance of counsel for his defense?

In other words, underlying the Dusky standard is the idea that the ability to understand the proceedings is related to the 6th amendment right to be informed of the nature and cause of the accusation. Underlying the Dusky standard is the idea that a defendant must be able to enjoy his right to the assistance of counsel.

In a competency examination, this is how you determine the cut-off point: is the defendant's mental disorder preventing him from enjoying these basic rights? The various competency "tests" you might employ in your evaluation cannot provide you with an answer to the ultimate question. They cannot tell you when the lack of understanding or the inability to cooperate with counsel rises to such a level that you must say that they are incompetent. The cut-off point is determined by logic and reasoning, not by test scores.  And the reasoning process you engage in involves your judgment as to whether or not those psycho-legal impairments are of such a severity that they compromise the defendant's rights to due process.

60 minutes Sell v. United States: Sell is concerned primarily with the question of whether or not a criminal defendant can be involuntarily medicated for the purpose of restoring and maintaining his competence. This case is of interest in that it provides discussion of a set of criteria for involuntary medication that are different from the traditional bases of either danger to self, danger to others, or grave disability. Consider this case in terms of the conflicting interest between being able to decide whether or not to take medications, and the interest of the State in prosecuting a crime.

60 minutes
People v. Wells: This was the first case involved in the establishment of California's diminished capacity doctrine, which was effectively gutted in 1981. It remains relevant, however, because the Court addressed the question of what types of mental state evidence can be admitted at the guilt phase of a trial, and what types of mental state evidence are reserved for a sanity phase. Current law on this topic basically embodies and reflects the reasoning presented in this case. An understanding of Wells provides insight into the often times confusing "diminished actuality" defense that is currently operative. An understanding of Wells provides the forensic pracititioner with insight into what is now permissible in the way of guilt phase mental state testimony. In the Wells case, the Court indicated that a psychologist might testify that a defendant "did not" form a mental state, but that a psychologist cannot say that a defendant "could not" form a particular mental state. This distinction would later be codified, and it is this argument that now determines what you can say, and what you cannot say while testifying at the guilt phase of a trial.

60 minutes
People v. Skinner: Skinner is one of two essential cases establishing the parameters of the insanity defense in post-Drew and post-1981 California law. First, it establishes that the word "and" actually means "or" as the conjuctive between the two prongs of the insanity test. Secondly, it establishes that knowing that an act is illegal does not equate with knowing that it was wrong.  

60 minutes  
People v. Stress: Stress repeats the conclusion drawn in Skinner with respect to the distinction between knowing moral wrong and knowing legal wrong. And it refines the meaning of moral wrong by noting that this refers to generally accepted standards, and not the subjective moral beliefs of the defendant. The implications are significant with respect to insanity assessments in which the finding is that the defendant suffers from personality disorder, instead of or in addition to mental disorder.

Comment:  Skinner and Stress are essential rulings that every clinician conducting insanity evaluations must know. What they indicate is that even when the defendant knows that his behavior is illegal, he might still be insane if he does not know that his behavior violates generally accepted moral standards.   The classic example is as follows:   "Yes, I ran from the police because I knew I would be arrested, but Jesus told me to kill that sinner, and Jesus said that this is what I should do."   The defendant is insane because their psychosis prevented them from knowing that their behavior was wrong, even though they knew it was illegal.    Contrast this situation to the following:   "Here in prison, you're supposed to kill the dude that gets in your face, that's our natural code of conduct."   In the latter case, the defendant believes that his actions are morally right and justifiable,  and does not know that the behavior is wrong,  but this understanding is the result of character disorder and his own "subjective moral beliefs," and in this situation, insanity does not apply.

60 minutes People v. Bobo: This is a prototype case of insanity in which the jury found the defendant to be sane. It provides insight with respect to the role of the psychologist, and particularly with respect to the debate as to whether the psychologist should express an ultimate opinion on sanity, or instead just provide data and analysis for the trier-of-fact. It also reviews in detail the admissibility and relevance of psychological findings at the guilt phase of a trial, following the abolishment of the diminished capacity defense.

Comment:  This is a classic case of insanity in which the jury ruled otherwise. Five clincicans said she was insane when she killed her children. The prosecution argued that maybe she just went crazy because she killed her children. The Court said that it was ok for the prosecution to argue this theory, even though it had no support from the experts.   Notice the treatment of the testimony of Dr. Mattiuzzi.   Mattiuzzi said that it was up to the jury to decide whether or not she was insane and that it was the expert's job to provide data to help the trier of fact decide.  The Court concluded that Mattiuzzi could not say whether or not she was insane.   The point is that the   "we just provide information and then let the trier-of-fact make the decision"  position is bogus.   If you are going to do insanity evaluations, you have to state an opinion.  Otherwise, they will dismiss your opinion and conclude that you didn't know.   Mattiuzzi would later make the same mistake while testifying in the Ellie Nesler trial.   The newspapers said:   "two Doctors say she was insane, two say she was sane, one didn't know."  Mattiuzzi never made this mistake again. home